接受胰腺切除术的患者面临胰腺外分泌功能不全和营养不良的风险。然而，这些并发症的发生率和相关的危险因素尚未得到充分研究。本研究旨在探讨胰腺切除术后胰腺形态、胰腺外分泌功能和长期营养状况的变化。我们评估了接受胰十二指肠切除术和远端胰腺切除术的患者的营养状况、胰腺形态参数和胰腺外分泌功能。根据体重变化、体重指数和骨骼肌质量评估营养状况。测量手术时胰实质质地、胰实质残余体积和胰管直径。使用N-苯甲酰基-L-酪氨酰基-对氨基苯甲酸排泄试验以及脂肪泻和非酒精性脂肪性肝炎的临床症状来测量外分泌功能。然后我们调查了潜在的因果关系。该研究纳入了 70 名患者。分别有 19 名 (27%) 和 15 名患者 (21%) 被诊断为中度和重度营养不良。大多数术前营养不良的患者术后也发现营养不良。大多数患者在胰腺切除术后，体重和骨骼肌质量都会下降，甚至从长远来看也是如此。分别有 36 名 (51%) 和 25 名患者 (36%) 发现亚临床和临床胰腺外分泌功能不全，胰腺导管腺癌、胰十二指肠切除术、胰管扩张、术前体重指数低和胰腺外分泌功能不全分级是导致胰腺外分泌功能不全的原因胰腺导管腺癌、胰管扩张、胰十二指肠切除术、术前体重指数低和胰腺外分泌功能不全是术后营养不良的危险因素。版权所有 © 2024 Elsevier Inc. 保留所有权利。

Patients undergoing pancreatectomy are at risk for pancreatic exocrine insufficiency and malnutrition. However, the incidence of these complications and the associated risk factors have not been sufficiently examined. This study aimed to investigate the changes in pancreatic morphology, pancreatic exocrine function, and long-term nutritional status after pancreatectomy.We assessed the nutritional status, pancreatic morphologic parameters, and pancreatic exocrine function in patients undergoing pancreaticoduodenectomy and distal pancreatectomy. Nutritional status was evaluated on the basis of body weight change, body mass index, and skeletal muscle mass. Pancreatic parenchymal texture at the time of surgery, remnant volume of the pancreatic parenchyma, and diameter of the pancreatic duct were measured. Exocrine function was measured using the N-benzoyl-L-tyrosyl-p-aminobenzoic acid excretion test and the clinical signs of steatorrhea and nonalcoholic steatohepatitis. We then investigated potential causal relationships.Seventy patients were included in the study. Moderate and severe malnutrition were diagnosed in 19 (27%) and 15 patients (21%), respectively. Most patients with malnutrition before surgery were also found to be malnourished postoperatively. Body weight and skeletal muscle mass decreased after pancreatectomy in most patients, even in the longer term. Subclinical and clinical pancreatic exocrine insufficiency was found in 36 (51%) and 25 patients (36%), respectively, and pancreatic ductal adenocarcinoma, pancreaticoduodenectomy, dilated pancreatic duct, low preoperative body mass index, and pancreatic exocrine insufficiency grade were found to contribute to postoperative malnutrition.Pancreatic ductal adenocarcinoma, dilated pancreatic duct, pancreaticoduodenectomy, low preoperative body mass index, and pancreatic exocrine insufficiency were risk factors for postoperative malnutrition.Copyright © 2024 Elsevier Inc. All rights reserved.